OBJECTIVES : Stroke is responsible for mortality and long-term disability in Argentina. Available treatments for stroke due to Large Vessel Occlusion (LVO) are Thrombolysis (IV-tPA) and Mechanical Thrombectomy (MT). However, despite its clinical benefits, MT coverage in Argentina and PAMI is low. A Budget-Impact Analysis (BIA) was conducted to estimate the financial impact of incorporating MT after IV-TPA in PAMI for the elderly.

METHODS : A BIA was carried-out based on a 6-step approach and a static model, from the PAMI perspective. The patient population was identified based on a funnel of medical criteria and local epidemiological data, for a lifetime horizon. The current and future treatment mix was identified based on manufacturer data and expert consultations. Costs were estimated from “módulos” in Argentinian pesos for acute and long-term phases, and changes in disease-related costs were calculated. Two scenarios were tested: with a staggering growth of 40% in procedures in 5 years and without growth in current MT procedures (15% of coverage).

RESULTS : The analysis showed that the scenario of increased access to MT begins to show savings (-0,02%) when compared to the scenario of maintained access after two years (AR$9.749.400.581versus AR$9.747.850.230). Financial savings derived from greater access to MT in the eligible population are observed in the third (AR$-187.310.897; -1,48%), fourth (AR$-504.162.548; -3,21%) and fifth year (AR$-958,029,266; -5,10%). In the fifth year, , 2.624 patients would have been treated at savings of -2,35% (AR$-1.592.084.696) in the scenario with increased MT access, instead of 984 cases at a greater financial impact.

CONCLUSIONS : The incremental costs of the device are offset by the costs of other categories (hospitalization and long-term costs). However, more patients are treated with a therapy that in the short term is more expensive than current alternatives, the better results of the patient result in avoiding the expense of worse levels of disability and illness.